<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Openid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-openid" class="form-control" name="row[openid]" type="text" value="{$row.openid|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bmi_reference')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bmi_reference" class="form-control" name="row[bmi_reference]" type="text" value="{$row.bmi_reference|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bp_reference')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bp_reference" class="form-control" name="row[bp_reference]" type="text" value="{$row.bp_reference|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Devid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-devid" class="form-control" name="row[devid]" type="text" value="{$row.devid|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Data')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-data" class="form-control " rows="5" name="row[data]" cols="50">{$row.data|htmlentities}</textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Tid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-tid" class="form-control" name="row[tid]" type="text" value="{$row.tid|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Ctime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-ctime" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[ctime]" type="text" value="{:$row.ctime?datetime($row.ctime):''}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Unionid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-unionid" class="form-control" name="row[unionid]" type="text" value="{$row.unionid|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Wechat_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-wechat_id" data-rule="required" data-source="wechat/index" class="form-control selectpage" name="row[wechat_id]" type="text" value="{$row.wechat_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Openid_fake')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-openid_fake" class="form-control" name="row[openid_fake]" type="text" value="{$row.openid_fake|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Ip_addr')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-ip_addr" class="form-control" name="row[ip_addr]" type="text" value="{$row.ip_addr|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Headimgurl')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-headimgurl" class="form-control" name="row[headimgurl]" type="text" value="{$row.headimgurl|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Nickname')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-nickname" class="form-control" name="row[nickname]" type="text" value="{$row.nickname|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Vender_id1')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-vender_id1" class="form-control" name="row[vender_id1]" type="number" value="{$row.vender_id1|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Vender_id2')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-vender_id2" class="form-control" name="row[vender_id2]" type="number" value="{$row.vender_id2|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Vender_id3')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-vender_id3" class="form-control" name="row[vender_id3]" type="number" value="{$row.vender_id3|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Wechat_user_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-wechat_user_name" class="form-control" name="row[wechat_user_name]" type="text" value="{$row.wechat_user_name|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Base_data')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-base_data" class="form-control " rows="5" name="row[base_data]" cols="50">{$row.base_data|htmlentities}</textarea>
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
